胱抑素C对评价全面达标治疗糖尿病肾病疗效的意义

The Significance of Cystatin C to Evaluate the Efficacy of Comprehensive Standard Treatment for Diabetic Nephropathy

目的探讨胱抑素c（CysC）对评价全面达标治疗糖尿病肾病疗效的意义。方法选取2010年8月-2012年3月苏州市立医院收治的糖尿病肾病患者56例，对其行强化短期全面达标治疗。记录患者达标情况，并观察所有患者CysC、收缩压（SBP）、舒张压（DBP）、空腹血糖（FBG）及糖化血红蛋白（HbAl。）、LDL-C、TG、血肌酐（Scr）、24h尿微量清蛋白（24h-MAlb）、尿酸（uA）水平。治疗3个月和6个月时，将FBG、血压、LDL-C、体质指数（BMI）、UA等指标达标患者35例作为观察组；上述1—4项指标达标患者21例作为对照组。结果治疗后，观察组SBP、UA、24h-MAlb、CysC水平低于对照组，肾小球滤过率（GFR）高于对照组（P〈0．05）。Pearson相关性分析显示CysC降幅与SBP、HbA。LDL-C、24h-MAlb、UA降幅呈正相关（r值分别为0．568、0．523、0．473、0．485、0．421，P〈0．05），与GFR降幅呈负相关（r=-0．679，P〈0．01）。结论CysC可以作为评价全面达标治疗糖尿病肾病疗效的内源性生物学指标。

Objective To investigate the significance of Cystatin C （CysC） in the evaluation the efficacy of compre- hensive standard treatment for patients with diabetic nephropathy. Methods 56 patients with diabetic nephropathy admitted Suzhou Municipal Hospital were chosen from August 2010 to March 2012, they were treated with short strengthen comprehensive standard treatment. The status of patient were records, and the levels of Cys C, systolic blood pressure （SBP）, diastolic blood pressure （DBP）, fasting blood glucose （FBG）, glycated hemoglobin （HbAlc）, LDL - C, TG, serum creatinine （Scr）, 24 h microalbuminuria （24 h - MAlb）, uric acid （UA） observed. 3, 6 months after Treatment, 35 patients with FBG, blood pressure, LDL- C, BMI, UA and other indicators complianced were chosen as observation group, and the other patients as control group. Results After treatment, the levels of SBP, UA, 24 h - MAlb, Cys C in observation group were lower than those of control group, GFR was higher than that of control group （ P 〈 O. 05 ）. Pearson correlation analysis showed that, a de- cline of Cys C was positively correlated with the decline of SBP, HbA1o, LDL - C, 24 h - MAlb, UA （ r = 0. 568, O. 523, 0.473, 0.485, 0.421; P〈0.05）, negatively correlated with GFR （r= -0.679, P〈0.01）. Conclusion Cys C can be used as a endogenous biological indicators to evaluate the efficacy of comprehensive standard treatment for patients with diabetic nephropathy.